1. TEAM ORGANIZATION Pharmacist Clerks/ Casher Office/Business Manager Billing/ Insurance Technician

2. ROLES AND RESPONSIBILITIES WHO AND BY WHAT ROUTE WILL COLLECT AND TRANSCRIBE PATIENT INFORMATION INTO A USABLE FORM FOR THE PHARMACIST? TIME KEEPER? CLINICAL ENCOUNTER? DOCUMENTATION/BILLING? FOLLOW UP RECOMMENDATIONS TO HEALTH PROVIDERS? PATIENT REMINDER?

3. QUIZ TO MAXIMIZE TIME FOR PROVIDING DISEASE MANAGEMENT WHO IS THE BEST STAFF PERSON TO ENTER OR TRANSCRIBE PATIENT INFORMATION INTO A USABLE FORM, FROM THE PATIENTS HEALTH HISTORY, INTO MTM EXPRESS? A. PHARMACIST B. PHARMACY TECHNICIAN C. CASHER D. OFFICE MANAGER

4. PHARMACIST TIME ENCOUNTER =TOTAL TIME A PATIENT IS PHYSICALLY AT THE PHARMACY =30-60MINUTES CONTACT TIME WITH THE PHARMACIST 15-30MINUTES PHARMACIST SHOULD ALWAYS FACTOR IN TIME FOR DOCUMENTATION. SHOULD NOT EXCEED 10 MINUTES. DEPENDING ON PATIENT LOAD THE PHARMACIST MAY NEED (SHOULD) TO BE OUT OF THE DISPENSING FUNCTION.

5. WORKFLOW BLOOD PRESSURE MANAGEMENT PROGRAM SCHEDULING VISIT (CLERK, TECHNICIAN) “ WE OFFER A BLOOD PRESSURE MANAGEMENT PROGRAM THAT IS CUSTOMIZED FOR YOU. YOU WILL BE ABLE TO SIT DOWN ONE ON ONE WITH A PHARMACIST WITH SPECIAL TRAINING IN BLOOD PRESSURE MANAGEMENT. I SEE THAT YOU ARE DUE TO PICK UP MEDICATION REFILL. OUR CERTIFIED PHARMACIST SEE PATIENTS ON TUESDAYS AND THURSDAYS AND THE NEXT AVAILABLE VISIT IS AT 8:30AM ON TUESDAY, WILL THAT WORK FOR YOU TO MEET WITH THE PHARMACIST AND PICK UP YOUR PRESCRIPTIONS”

6. WORKFLOW BLOOD PRESSURE MANAGEMENT PROGRAM SCHEDULING VISIT (CLERK, TECHNICIAN) “ GREAT. I HAVE YOU SCHEDULED FOR 8:30AM ON TUESDAY, MONTH DAY. SINCE THIS IS YOUR FIRST VISIT THERE ARE A FEW FORMS TO COMPLETE. WE CAN MAIL THE FORMS TO YOU OR YOU CAN ARRIVE ~15 BEFORE YOUR VISIT TO FILL THEM OUT.”

7. RELEASE OF MEDICAL RECORDS

8. MEDICAL HISTORY

9. WORKFLOW BLOOD PRESSURE MANAGEMENT PROGRAM SCHEDULING VISIT (CLERK, TECHNICIAN) DAY BEFORE VISIT “HELLO MR. SMITH, I AM CALLING FROM XYZ PHARMACY TO REMIND YOU OF YOUR UPCOMING BLOOD PRESSURE APPOINTMENT ON TUESDAY, MONTH DATE AT 8:30AM. PLEASE ARRIVE 15 AHEAD OF TIME TO COMPLETE INITIAL VISIT PAPERWORK”

10. WORKFLOW BLOOD PRESSURE MANAGEMENT PROGRAM VISIT DAY PATIENT IS GREETED BY CLERK/TECHNICIAN AND PAPERWORK IS COMPLETED. ELECTRONIC DATA IS ENTERED. PHARMACIST IS ALERTED THAT PATIENT IS HERE FOR HYPERTENSION MANAGEMENT AND REFILLS ARE READY.

11. WORKFLOW

12. PHARMACIST MEETS WITH PATIENT “ THANK YOU FOR COMING MR. SMITH. TODAY WE WILL BE ABLE TO SPEND 30 MINUTES TOGETHER TO WORK ON BLOOD PRESSURE CONTROL. I SEE FROM YOUR HEALTH HISTORY YOU HAVE SOME QUESTIONS ON MEDICATION SIDE EFFECTS AND DIET, TELL ME MORE ABOUT THAT.”

13. WORKFLOW “IT LOOKS LIKE WE ARE COMING TO A CLOSE OF THIS VISIT. TO SUMMARIZE YOUR MEDICATION CONCERN YOU ARE EXPERIENCING MILD FATIGUE WITH THE CARVEDILOL AND AS TALKED ABOUT THIS IS A COMMON SIDE EFFECT. WE WILL CONTACT YOUR PROVIDER ABOUT A SLOWER INCREASE IN THE DOSE SCHEDULE. YOU WILL CALL IN ONE WEEK TO LET US KNOW HOW YOUR FATIGUE IS DOING. DID I MISS ANYTHING?” “GREAT, WE WILL SEE YOU IN ONE MONTH FOR FOLLOW UP TO SEE HOW YOUR FATIGUE IS DOING, AT THAT TIME REVIEW YOUR LABS FROM YOUR DOCTOR AND REFILL YOUR MEDICATIONS. I WILL HAVE CARLA OUR CASHIER COME AND SCHEDULE YOUR NEXT VISIT.”

14. WORKFLOW INTERNAL FACTORS POSITIVE STAFF ATTITUDES INCENTIVES FOR MOTIVATION PHARMACY DESIGN AND WORKFLOW PROMOTION OF A PROFESSIONAL HEALTH ENVIRONMENT Rovers JP, Currie JD, Hagel, HP, McDonough RP, Sobotak JL. Creating the infrastructure. In: A Practical Guide to Pharmaceutical Care. Washington; American Pharmaceutical Association. 1998. pp207-12.

15. ROLES AND RESPONSIBILITIES WHO AND BY WHAT ROUTE WILL COLLECT AND TRANSCRIBE PATIENT INFORMATION INTO A USABLE FORM FOR THE PHARMACIST? (CLERK, TECHNICIAN) TIME KEEPER (CLERK, TECHNICIAN, OFFICE MANAGER) CLINICAL ENCOUNTER (PHARMACIST) DOCUMENTATION/BILLING (PHARMACIST) FOLLOW UP (CLERK, TECHNICIAN) RECOMMENDATIONS TO HEALTH PROVIDERS PATIENT REMINDER